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Homebirth: Whom to Invite

by Rebecca Britt Walton

For the ease of reading I used the female tense for birth companion(s). I understand that some may have male birth companions.

Having a home birth affords you total control of who attends your birth. Choosing your birth companions, however, can be one of the main sticking points when planning your birth. Should you choose an intimate birth with just your partner and midwife? Or invite your closest friends and family also? What about your other child or children? Should you allow them to be at your birth? Should you invite your family pets to be a part of this experience? Furthermore, when you finally decide on whom to invite, how should you prepare them for the birth that you want?

Choosing attendants

Choosing who attends your birth can be difficult. If this is your first birth you have no previous experience from which to draw and you will probably try to cover every situation. If this is your second or greater birth, you may concentrate on what you would like to improve from your previous birth(s).

How private do you want your birth to be? That is the first thing you have to decide. A birth with just you and/or your partner and midwife may be very empowering and special or, isolating and depressing. A birth that includes your family and friends can be one where a sense synergy prevails or can, on the other hand, lead to distractions.

How do you know which to choose? A good approach is to read birth stories, talk to your midwife and to other women who've given birth at home to get a feel for the dynamics and what to expect. Then search your soul and consider your personality and that of your partner and the role that he wants in the birth. Visualize your birth in both settings, without guests and with them and make note of what feels right. Understand that although you want to get it right and make the best choices, you may wish, at the end of your birth, that you had done it differently. That's okay; birth is emotionally unpredictable and the decisions you make and the plans you have while pregnant may not follow the same path when you're actually giving birth.

If you decide that an intimate birth is for you then you won't have to choose whom to invite. If you want your birth to be a family and friend affair, however, you must choose your birth companions. You will want to choose companions that will complement your birth plan. Never choose someone out of obligation. Following are some questions to ask yourself regarding each person you're considering; remember there is no right or wrong answer:

• What can she do for me emotionally and physically?
• Is she someone I would not want to show up at my door when my house is a mess?
• What are her personality strong points? Weak points?
• Does my partner get along with her?
• Can I easily ask her to do things for me?
• How will she interact with my other birth companion(s)?
• Would I feel comfortable being naked around her?
• Can she tolerate me being naked?
• How will she act around my child or children?
• Could I ask her to do laundry, cook, and/or clean?
• Do I hold a deep enough relationship with her that if I decide not to call her to come to the birth I can contact her to let her know the baby was born and why she was not ultimately invited?

The invitation

Once you decide who will attend your birth, you must then invite them. Remember, that although you know that an invitation to a birth is sacred and special, the person whom you invite may not think so. One mother was disappointed when after much thought she invited a family member who responded with, "Ugh. I don't know. Those birth shows on TV really gross me out." Leave your invitation open and give your invitee a chance to think about your request before answering. Although you'll be disappointed if your invitee says "no" realize that to be of benefit to you your birth companions need to want to be a part of the experience. No one should attend your birth out of obligation.

Also, leave yourself the option to change your mind once you've asked someone to attend. Tell your invitee that birth is emotionally unpredictable and at the last minute you may change your mind about whom you want to attend; you may decide that a more intimate birth is best and not invite any of your birth companions, or you may invite part of them. Also let them know that birth is physically unpredictable and there's a possibility you'll give birth so quickly you can't call everyone to come.

Understand though that there are consequences to playing this card. If the baby comes so fast that no one is able to attend, then all should be well. However, if you invite some of the birth companions and not others there can be hurt feelings and problems may start. In some cases it would be better that the birth companion not be invited in the beginning than to be invited and then not called for the birth. When a person says "Yes" to your birth party invitation, you must expect that she will be spending a lot of time wondering what the birth will be like, wondering what her role will be in the birth and anticipating the time when she will receive your phone call. This may be one of the biggest moments in her life. If you want her at your birth, you must value her dedication to you.

As a mother who has given birth at home and been invited to a birth, Linda has experienced both sides:

"It was hard to decide who I wanted to attend my birth. After coming to a decision and inviting everyone I had doubts. I worried that there would be personality conflicts and I thought perhaps I'd made a mistake in choosing those I invited. However, when I went into labor I decided to call all of my team. It worked out beautifully, there were no problems, and I saw sides of my friends that I'd never witnessed before.

A year later, when I was invited to attend my friend's birth I was very excited, but knew that she also may have doubts and I may not get invited in the end. I tried to prepare myself for the possible disappointment, but I also spent a lot of time thinking about the event and just how powerful it was going to be. Unfortunately, someone who attended the birth informed me of the birth a day after the baby was born. I was very disappointed, but mostly I felt rejected. I know if I ever have another baby I will only invite those that I have a close enough relationship to that in the event that I decide not to call them, I can inform them of the baby's birth and tell them why they were not invited."

And Tiffany a home birth doula shares her advice about when to call your companions.

"I've found that the first people that you call when you are in labor are the ones you feel most comfortable with as your labor progresses. If you've invited 10 people to attend your birth and you call the first 5 during labor, it is very difficult to call the last 5 once labor has progressed. You get used to the first 5 and get an energy flowing with them that does not encourage interruption."

Children at the birth

Many families choose a birth at home particularly because it allows their other child or children to be a part of the family-changing event. There are those however, who feel that birth is a private affair and make other arrangements for their other children during the birth. If you have another child or children you may wonder if it's best for them to attend. Of course this will be a topic that each family will have to discuss and decide what is right for them.

If your other child/children do not attend you will have to arrange for childcare and plan how to get the child/children to the caregiver. If your other child (or children) will attend, depending on their age, you may pre-arrange for one of the birth party members to attend to him or her. You will also need to prepare your child/children for the birth.

You can begin this preparation the day you tell your child you're expecting. Talk about how the baby's growing and what changes will happen within your body. Take them to your prenatal visits. Let them be a part of listening to the baby's heartbeat and watching the midwife palpate your stomach. Most midwives have posters and life-size props of the pelvis and baby and she can demonstrate how the baby will come out. Closer to the birth you can also talk about the sounds you may make. You can have your child or children practice moaning and making primal sounds with you. You can talk about what they may see when the baby comes out and what the midwife will do. And you can discuss the child's role in the birth i.e., cutting the umbilical cord, helping to catch the baby etc. and make plans.

Although you know your child best, you may be surprised with his or her reaction to birth. Some well-prepared children do not handle the birth well and become emotional and other children who've previously acted aloof about the impending birth may be drawn in and fascinated by the experience. It is good to keep an open mind. It is also a good idea to have a designated person to care for your child. Assigning someone to watch after your older child or children will allow you and your partner to focus on birthing the new baby. The caregiver can take the older child out of the room if it becomes overwhelming for you or the child and they can also watch your child while you labor and bring them to you when the baby is about to be born. You will want to choose a person with whom your child feels safe, a person who supports your decision to birth at home and someone you can call at any time of the day or night.1

Pets and homebirth

Last but not least, you must consider your pets if you have any. Although you may want to include your pet in your birth you may want to consider the overall emotional effect that the birth may have on furry family members, dogs in particular. According to Jennifer Shryock, Certified Dog Behavior Consultant and developer of Dogs & Storks,. witnessing a birth may impact your dog negatively. "Many dogs that attend such a situation," she says, "often become sick shortly after." She attributes this to stress. As she states, "There is no way to communicate fairly to our companions that all is well. They are wiser then we know. They sense the stress and different situation no matter what we do." She speculates the association between scent and stress may contribute to fear and confusion.

"Babies smell like amniotic fluid and the dog may associate the baby with whatever phase of labor Mom was in when her water broke or the amniotic scent appeared." She says, "So, if mom is in full blown labor and vocalizing and this unique scent is there, then once baby comes....what is the association for the dog? Fear, panic, confusion?"

In addition to considering the emotional impact on your pet (especially dogs), you must also consider how he or she will fit into the birth space. Cats marking their territory or birth kit items or dogs "protecting" their owner(s) is not how midwives want to start a birth. Most midwives however, are open-minded when it comes to animals at birth; some even gave birth themselves with their pets present. They have limits, nevertheless, and most admit that dogs and cats are better outside the birth room.

Some common concerns midwives have are:

Possessive animals that are hostile to the birth attendants

Animal turning things over and ruining supplies

Pets contaminating sterile equipment

Excitement and hyperactivity of animals

Pets getting in the way, wanting to put their noses in everything

Pet hair on equipment

Disruptive vocal pets

Although you love and understand your dog, your midwife might not share this affection, especially at a time when she needs to be focusing on you and the progression of your birth. Therefore, you may decide to keep your pet in another room until after the baby is born. If you believe it is best for your pet to be present at the birth you may want to treat your pet as you would another child. "Have several plans that happen in times of stress and make arrangements," says Jennifer Shryock.

Preparing your birth companions

So, how do you prepare your birth companions for a birth at home? You throw a birth preparation party! A good time for this is at your 36-week home prenatal appointment. Invite your birth companions to your home, perhaps serve a light meal or arrange a potluck dinner.

Explain to them that this will be a time when they will meet each other and your midwife, learn about your birth plan, get an idea of what to expect at a home birth and become familiar with your home. Your midwife will be there to answer questions and you can discuss what your desires for your birth are and how you feel your birth companions can best serve you. Your companions can get a feel for your home, and you can acquaint them with such things as the kitchen and the laundry room. They can view your birth kit and see where you plan to give birth.

Here are some ideas and topics to cover at your birth party:

Introductions -- let everyone tell who they are and how they know you.

Explain why you want to give birth at home.

Explain your "birth plan" -- describe what you want and what you don't want to happen at your birth. Talk about your previous birth experience(s) and what you'd like to be the same and different with this birth.

Tell your companions why you chose them and what you hope their personality or talents will add to your birth.

List possible jobs and functions. Ask for what you need and take volunteers.

Go over driving directions, work out any questions, and get contact information from each participant. Find out at what point in labor that they want to be contacted.

Watch a birth video to familiarize guests with home birth.

A good way to make sure that your companions remember all the topics that you cover at your party is to create a keepsake booklet.

Here are some things that you could include in your book:

A letter to the birth companion

The reasons why you choose a birth at home

Your hopes and plans for birth

Possible job opportunities

Stages-of-labor chart

List the ways your companions can be helpful

A list of things for your companion to put in her travel bag

Directions to your home and contact information

Previous birth story

A birth party allows you to experience the energy created by your birth companions. You will be able to detect any negative energy and decide on how to remedy it before the birth. It is also the beginning of the bond you will soon complete with your birth companions.

There is a lot to planning your birth and although choosing if and who to invite can be a big sticking point it is important to remember that this is YOUR birth. You'll only get to do it a few times in your life and whether this is your first baby or your 7th, each birth is a different journey. It is often filled with moments of vulnerability, doubt, and exhilaration. Who is best to come with you on this journey? Will it be one of intimacy or one you want to share with many others? If you put a lot of thought and love into your decision, trust your first instincts and do not give in to guilt or obligation you will have done all you can in choosing the best companions for your birth. This is a journey that can create a beautiful bond between you and those that attend and the day of your birth can be one you will all remember with fondness.

1. Home Birth by Alice Gilgoff Published 1978, 2000 p.117

Rebecca Britt Walton lives in North Carolina with her husband and two boys. After the birth of her first son in 2003 she started researching and writing and collaborated with her sister who is a web designer and together they created www.nchomebirth.com. She loves being an advocate for homebirth and is studying to be a doula and childbirth educator on her path to becoming a midwife.